Prescription for Harm
Diet Industry Influence, Public Health Policy, and
the “Obesity Epidemic”
The girth of Americans is increasing … clothing dealers show that the average Ameri-
can of 1889 was easily fitted with a waistband of 46 inches. In 1899 he requires one of
47 ½ inches. At this rate of increase he will reach in 1909 a circumference of 49 or 50
inches … The dairy counters (and) labor-saving inventions, the elevators, telephones
and other contrivances supposed to make people indolent and fat, have their part in
producing this result.
—JAMA, June 28, 1899 (quoted in Reiling, 1999, p. 1502).
Messages of alarm about Americans' weight gain due to fast food and sedentary living that fill the pages of newspapers and public health policy forums today are eerily similar to the concerns voiced over one hundred years ago. Fear of fat is not new, nor is the promotion of pills, potions, surgery, and other “cures.” What is new in the last fifty years, most especially since 1994, is the extent to which the diet and weight loss industry has moved from the sidelines to the center of American life, managing to dramatically increase its influence and profits without ever increasing product effectiveness. The failure rate for sustained weight loss has remained constant at 90–95% (National Institutes of Health Technology Assessment Conference Panel, 1992).
Despite this failure, bariatric medicine—diet doctors and weight loss surgeons— has become very influential in the federal government's public health decision making. Drug company money funds research, public health education, and policy forums; former drug company consultants hold key federal positions and fan the flames of fear over an “obesity epidemic” (Moynihan, 2006). With the National Institutes of Health leading the charge by defining over 60% of Americans as “overweight or obese,” the majority of the population is now at risk for the negative health consequences of weight stigma. Because no effective weight loss treatment exists to allow escape from this stigma, just how is the public to protect itself?